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Suspect-and-test checklist

IgA nephropathy

Diagnosed only by kidney biopsy. About 60% of adult cases are found incidentally on urinalysis.

ICD-10-CMN02.B1 to N02.B9Trial Friend for Clinicians

1Red flags present

Urine

Kidney and blood pressure

Context

2Already labeled as

3Family to test

4Testing, in the order the sources describe

  1. Urinalysis with microscopy and red cell morphologyAUA/SUFU: 3 or more red cells per high-power field is microhematuria.
    Result
  2. Quantify proteinuriaUPCR or 24-hour protein. Children: first-morning UPCR, which also excludes orthostatic proteinuria.
    Result
  3. Serum creatinine and eGFRSchwartz formula in children.
    Result
  4. C3, serum IgA and serologies as appropriateANA, dsDNA, ANCA; hepatitis B, hepatitis C and HIV. IPNA lists a normal C3 among its criteria.
    Result
  5. Kidney ultrasoundIPNA: required before biopsy in children.
    Result
  6. Kidney biopsy and reportKDIGO 2025: consider in adults with proteinuria of 0.5g/day or more; ERA adds reduced eGFR. Needs dominant or co-dominant IgA; Oxford MEST-C.
    Result
  7. Genetic testing in familial hematuriaFamily history of hematuria and CKD: consider collagen IV disease.
    Result

5Results the sources say do not rule it out

  • Proteinuria under 0.88g/g. In the Travere-funded RaDaR cohort, about 20% to 30% still reached kidney failure within 10 years.
  • Hematuria during an infection fits IgAN; hematuria 1 to 3 weeks after, with low C3, fits post-infectious disease.
  • A random urine in a child may reflect orthostatic proteinuria. Use a first-morning sample.
  • No blood or urine biomarker diagnoses IgA nephropathy. Mesangial IgA alone is not specific.

6Specialists the sources name

Diagnosis codes: Recurrent and persistent immunoglobulin A nephropathy with: N02.B1 glomerular lesion; N02.B2 focal and segmental glomerular lesion; N02.B3 diffuse membranoproliferative glomerulonephritis; N02.B4 diffuse membranous glomerulonephritis; N02.B5 diffuse mesangial proliferative glomerulonephritis; N02.B6 diffuse mesangiocapillary glomerulonephritis; N02.B9 Other recurrent and persistent immunoglobulin A nephropathyCodes patients often carry before diagnosis are listed in the online guide.
Full guide and sourcesEvery point here is sourced in the online guide, which also has a patient note to print.
Trial Friend, trialfriend.com/for-clinicians. Key sources: NIDDK (2022); KDIGO 2025 executive summary; KDIGO 2025 IgAN guideline; ERA working group on KDIGO 2025; JAMA review (2026); IPNA pediatric recommendations (2024); all 19 with links in the online guide. Checked November 8, 2026. A reference checklist for licensed clinicians that summarizes published sources. It is not a diagnostic tool, a score or a protocol, and it does not replace clinical judgment, local practice or the prescribing information. Not coding advice. Trial Friend never receives anything written or typed on this sheet.